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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/214101
Assessment of bone loss adjacent to lower second molar in case of third molar impaction and other findings using Orthopantomography (OPG)
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[eng] INTRODUCTION: Dental impaction is a pathological situation in which a tooth is totally or partially included in the jaw or maxilla bone. Different teeth are noticeably prone to impaction phenomena, including the canine and upper third molar, third molar, and lower canine. However, the lower third molar is considered the most common impacted tooth, accounting for 98% compared to other impacted teeth. It usually erupts between the ages of 17 and 24. The overall prevalence of impaction of the lower third molar is estimated to be around 24%, with no gender predilection between men and women. There are factors that cause a tooth to not erupt in the expected time, including lack of space, poorly positioned dental germs, abnormal eruption pathway, and alterations in jaw development. Mandibular third molar impaction has many complications in the adjacent soft tissue and second molar. Thus, pericoronitis is one of the consequences caused by impaction, which manifests itself as inflammation of the gum tissue that covers it. Other complications include distal caries, bone loss adjacent to the second molar, cystic formation, and neoplastic changes. The different positions of impacted mandibular third molars can complicate the maintenance of oral hygiene and control plate. Therefore, the periodontium manifests the formation of pockets that facilitate bone loss on the distal aspect of the second molar. In addition, the mandibular third molar is located near the inferior mandibular canal which contains the inferior alveolar nerve, the artery and the corresponding vein. Surgical extraction of such a tooth may pose a risk of nerve injury leading to dysesthesia or paresthesia. In addition, the third molar removal procedure can put pressure on the bone that can lead to fracture of the angle of the jaw. Finally, extraction can affect the lower 2nd molar. Therefore, clinical and diagnostic procedures are essential to address the position of the impacted tooth, the associated pathology, the proximity to the nerve canal, and the decision to intervene.
Orthopantomography (OPG) is an imaging technique routinely used in the dental office, representing the jawbone and jaw in a single image. It has the advantage of exposing dental and bone changes in the oral cavity, including impacted teeth. Among the advantages of OPG are its speed and ease, especially the 2nd molar and the canal inside the realization, better
patient cooperation and acceptance, complete coverage of dental arches and related structures (more anatomical structures can be seen on a panoramic film than in a full series of intraoral x-rays), simplicity, and low radiation exposure for the patient, compared to the most advanced imaging tool, cone beam computed tomography (CBCT). As impaction of the third molar is one of the dental pathologies that dentists frequently see, the determination of the position and relationship with nearby structures, especially the 2nd molar and the lower dental canal, can be predicted using OPG.
HYPOTHESIS: Impaction of the third molar causes bone loss distal to the second molar, therefore there will be bone gain distal to the second molar after extraction of the third molar.
OBJECTIVE: To determine the distal bone loss of the lower second molar associated with impaction of the third molar and to analyze its evolution after the extraction of the third molar.
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ASSIRI, Hassan. Assessment of bone loss adjacent to lower second molar in case of third molar impaction and other findings using Orthopantomography (OPG). [consulta: 1 de desembre de 2025]. [Disponible a: https://hdl.handle.net/2445/214101]